妊娠期急性胰腺炎血脂代谢特点与病情特征的临床研究

发布时间：2018-05-14 01:29

  本文选题：急性胰腺炎 + 妊娠　； 参考：《浙江大学》2014年硕士论文

【摘要】：背景和目的： 妊娠期急性胰腺炎是一种严重的妊娠并发症,起病急、进展快,如诊治不及时,孕产妇及围产儿病死率高,严重威胁母婴健康。近年来其发病有增多的趋势,并已成为部分地区孕妇急腹症中致孕产妇死亡的首位病因,因此了解妊娠期急性胰腺炎的发病原因、机制和临床特点,对于治疗及预防妊娠期急性胰腺炎发生具有十分重要的意义。本文通过总结2003年1月至2013年12月杭州市第一人民医院收治102例的妊娠期急性胰腺炎患者血脂代谢特点和病情特征,分析血脂结果与妊娠期急性胰腺炎发作以及病情程度的相关性,提高对妊娠期血脂特点和妊娠期急性胰腺炎病情特点的认知。 方法： 将102例妊娠期急性胰腺炎患者依据妊娠时期不同分为早、中、晚期三组,每组依据胰腺炎病情严重程度分为轻、中、重度三组,随机选取同期本院体检中心100例正常育龄妇女和同期在本院孕检早、中、晚孕期孕妇各100例作为对照组,分析每组患者入院时血脂特点(高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、甘油三酯(TG),确定妊娠不同时期血脂结果与胰腺炎发病和病情特点的关系。 结果： (1)102例妊娠期急性胰腺炎患者,妊娠早、中、晚期分别占18.6%(19/102)、25.5%(26/102)、55.9%(57/102)；轻、中、重度分别占49.0%(50/102)、40.2%(41/102)、10.8%(11/102)；82.4%(84/102)妊娠期急性胰腺炎患者伴高脂血症(血清TG≥1.7mmol/L),在妊娠中晚期,中重度急性胰腺炎发生率为62.7%(52/83),高脂血症性中重度急性胰腺炎占84.6%(44/52)。 (2)早期妊娠中,轻度胰腺炎组、正常妊娠组、非孕妊娠组之间血脂水平(HDL-C、LDL-C、TC、TG)无差别(P0.05),中晚期妊娠中,正常妊娠组血脂水平高于非孕组(P0.05)；轻度胰腺炎组血脂水平与正常妊娠组之间无差异(P0.05)；而LDL-C、TC及TG水平在中重度急性胰腺炎组均高于轻度组(P0.05),其中TG水平明显高于轻度组(P0.01),但TG在中、重度急性胰腺炎组之间无统计学差异(P0.05)。 (3)2例妊娠晚期高脂血症性重度急性胰腺炎患者死亡,死亡率1.9%(2/102)；中期妊娠中度急性胰腺炎终止妊娠率83.3%(10/12)；40例晚期妊娠中、重度急性胰腺炎均行剖宫产术终止妊娠,死胎和娩出后死亡8例,围生期婴儿死亡率14.0%(8/57)。 结论： 妊娠期轻度急性胰腺炎可伴有轻度高脂血症(TG≤5.6mmol/L),但病情与血脂水平无相关性；而在妊娠中晚期,明显高脂血症是导致中重度急性胰腺炎发生和孕妇死亡的重要原因,需终止妊娠,围生期婴儿死亡率高,控制血脂TG5.6mmol/L对预防妊娠期中重度急性胰腺炎有重要意义。
[Abstract]:Background and purpose: Acute pancreatitis of pregnancy is a serious complication of pregnancy, which has a rapid onset and rapid progress. If diagnosis and treatment are not timely, maternal and perinatal mortality is high, which is a serious threat to maternal and infant health. In recent years, the incidence of acute pancreatitis has been increasing, and has become the first cause of maternal mortality in pregnant women with acute abdomen in some areas. Therefore, to understand the pathogenesis, mechanism and clinical characteristics of acute pancreatitis of pregnancy. It is of great significance for the treatment and prevention of acute pancreatitis in pregnancy. From January 2003 to December 2013, 102 patients with acute pancreatitis during pregnancy were treated in Hangzhou first people's Hospital. To analyze the correlation between blood lipid and severity of acute pancreatitis in pregnancy, and to improve the cognition of the characteristics of serum lipids in pregnancy and the condition of acute pancreatitis in pregnancy. Methods: 102 patients with acute pancreatitis of pregnancy were divided into three groups according to pregnancy. Each group was divided into three groups according to the severity of pancreatitis: mild, moderate and severe. 100 normal women of childbearing age and 100 pregnant women of early, middle and late pregnancy were randomly selected as the control group. The characteristics of serum lipids (HDL-CU, LDL-CU, TCX, TGG) at admission were analyzed in each group. The relationship between the results of serum lipids in different periods of pregnancy and the incidence and disease characteristics of pancreatitis was determined. Results: One hundred and two patients with acute pancreatitis in pregnancy, early, middle and late pregnancy accounted for 18.6% of all patients with acute pancreatitis during pregnancy (serum 鈮，

本文编号：1885726